Individual
PIERRE WISLY CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
84 CORBIN AVE, EAST PATCHOGUE, NY 11772-4542
(631) 480-6073
Mailing address
84 CORBIN AVE, EAST PATCHOGUE, NY 11772-4542
(631) 480-6073
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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